Individual
EMILY JO FULLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4000 HIGHWAY 9 E, LITTLE RIVER, SC 29566-7833
(843) 390-8100
Mailing address
3980 HIGHWAY 9 E STE 340, LITTLE RIVER, SC 29566-8165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29150
SC
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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